Characteristics of Systemic Diseases in the Breast

Clinical, Imaging and Pathologic Features

Shahla Masood

Disclosures

Women's Health. 2012;8(5):593-599. 

In This Article

Abstract and Introduction

Abstract

Despite tremendous efforts placed on advances in diagnosis and treatment of the spectrum of breast disease, the impact of systemic diseases on the breast has remained under recognized. Distinction between a variety of benign breast diseases versus those that are manifestations of a systemic disease is critically important for appropriate treatment planning and follow-up of patients. This article is designed to provide an overview of different systemic diseases that can present as a breast lesion. Attempts are made to highlight the significance of the distinction between benign breast disease versus benign conditions that present as the result of a systemic disease. Naturally, distinction between any benign condition versus breast carcinoma is a part of the evaluation process.

Introduction

Similar to the spectrum of changes of benign, premalignant and malignant breast disease, systemic disease may manifest as a palpable lesion, an image-detected abnormality or present with skin changes and/or breast pain. Familiarity with clinical imaging and morphologic features of systemic disease in the breast is most useful in rendering an accurate diagnosis and recommending an appropriate follow-up therapy. In addition, this recognition may potentially alleviate the anxiety of a patient when the diagnosis of a primary breast cancer is excluded. It is generally known that aside from localized infectious and inflammatory processes, the breast can be involved in a variety of systemic diseases as the result of a generalized illness. Although manifestations of systemic disease may be rare, their occurrence is an alarming experience. This is best exemplified by the increasing number of tuberculosis cases related to HIV infection. Mammary tuberculosis has even been reported in a patient who was not initially known to be seropositive for HIV and was thought to have a pyogenic breast abscess. In this case, further analysis of mycobacterial smears, culture and serology for HIV infection resulted in an accurate diagnosis. Therefore, awareness of the association between systemic processes with localized breast mass of an unusual nature is an important step in the accurate characterization of breast lesions.[1]

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